The volume of TV advertisements during the ACA's first enrollment period was associated with increased insurance coverage

Pinar Karaca-Mandic, Andrew Wilcock, Laura Baum, Colleen L. Barry, Erika Franklin Fowler, Jeff Niederdeppe, Sarah E. Gollust

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


The launch of the Affordable Care Act was accompanied by major insurance information campaigns by government, nonprofit, political, news media, and private-sector organizations, but it is not clear to what extent these efforts were associated with insurance gains. Using county-level data from the Census Bureau's American Community Survey and broadcast television airings data from the Wesleyan Media Project, we examined the relationship between insurance advertisements and county-level health insurance changes between 2013 and 2014, adjusting for other media and county- and state-level characteristics.We found that counties exposed to higher volumes of local insurance advertisements during the first open enrollment period experienced larger reductions in their uninsurance rates than other counties. State-sponsored advertisements had the strongest relationship with declines in uninsurance, and this relationship was driven by increases in Medicaid enrollment. These results support the importance of strategic investment in advertising to increase uptake of health insurance but suggest that not all types of advertisements will have the same effect on the public.

Original languageEnglish (US)
Pages (from-to)747-754
Number of pages8
JournalHealth Affairs
Issue number4
StatePublished - Apr 1 2017

Bibliographical note

Funding Information:
This research was previously presented at the American Society of Health Economists' ASHEcon, in Philadelphia, Pennsylvania, June 12-15, 2016 (oral presentation), and at the AcademyHealth Annual Research Meeting, in Boston, Massachusetts, June 26-28, 2016 (poster presentation). The authors received funding from the Robert Wood Johnson Foundation SHARE program (co-principal investigators Sarah Gollust and Erika Franklin Fowler, Grant No. 72179), Wesleyan University (Laura Baum and Erika Franklin Fowler), and McKnight Land-Grant Professorship, University of Minnesota (Sarah Gollust). [Published online March 15, 2017.]

Publisher Copyright:
© 2017 Project HOPE - The People-to-People Health Foundation, Inc.


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